I, the undersigned, do hereby state that I am a registered voter for the public office is hereby being made, that my present place of residence is truly stated opposite my signature, and that i do herby nominate the following named person as a candidate for election to public office to be voted for at the election to be heldon the 4th day of November, 2008 Name Of Candidate: Isaiah Matos Public Office: New York Congressional District 14 Representative Place of Residence: ___________________________ ___________________________ I,_________________________state: I am a duly qualified voter of the state of New York, and I am also duly qualified to sign the petition. I now reside at________________________________________. Each of the individuals whose names are suscribed to this petition sheet containing_____ signatures, suscribed the same on the dates above indicated and identified themselve as the individual signed. I understand that this statement will be accepted for all purposes as the equivalent of an affadavit and shall subject me to the same penalties as if I had been duly sworn. ______________ ___________________________ Date Signature _______________ _____________________________ Town/city County PLEASE READ!!!! YOU HAVE TO BE A REGISTERED VOTER, AND INCLUDE YOUR ADDRESS AND COUNTY IN THE NOTES AREA, OR YOUR DIGITAL SIGNATURE IS OF NO VALUE ACCORDING TO NEW YORK STATE LAW. THANK YOU FOR THE SUPPORT, AND PLEASE DO NOT USE THE \"ANONYMOUS\" OPTION

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